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The Oregon Administrative Rules contain OARs filed through August 15, 2014
 
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HEALTH LICENSING OFFICE

 

DIVISION 420

PRACTICE STANDARDS

331-420-0000

Practice Standards

Licensed denturists must adhere to the following practice standards:

(1) Oral Health Certificate. Denturists must either have an oral pathology endorsement on their license, or if they have not qualified for and received the endorsement, must comply with requirements for obtaining an Oral Health Certificate as described in ORS 680.545 and OAR 331-410-0080.

(2) Patient Record. A licensed denturist must record, update and maintain documentation for each patient relevant to health history, clinical examinations and treatment, and financial data. Documentation must be written or computerized. Records must include but are not limited to the following:

(a) Patient data, including name, address, date and description of examination;

(b) Evidence of informed consent (may be in the form of an acronym such as "PARQ" to denote procedure, alternatives, risks and questions);

(c) Date and description of treatment or services rendered, and any treatment complications;

(d) Health history as applicable; and

(e) Any other information deemed appropriate to patient care.

(3) Clinical Examination. Licensed denturists must conduct and record a clinical examination of each patient that will include at a minimum, information relative to:

(a) Appearance of gingiva, oral mucosal membranes, pharynx, tongue and all other oral soft tissue; and

(b) Oral conditions that may affect successful denture construction and use.

(4) Record Retention. Patient documentation, written or archived electronically by computer, must be retained for a minimum of seven years and available upon request by the Agency.

(5) Minimum Standards of Acceptable Patient Care. Licensees must adhere to the following practice standards in rendering acceptable patient care:

(a) Maintain accurate patient records;

(b) Seek consultation/referral if indicated;

(c) Make accurate representation to the patient on services provided;

(d) Provide or arrange for continuity of care or emergency treatment for a patient currently receiving treatment;

(e) Adhere to current denture technology practices and standards including use of materials;

(f) Adhere to Centers for Disease Control and Prevention infection control standards and practices;

(g) Wash hands using a germicidal or antiseptic soap and water before and after every patient;

(h) Wear disposable gloves when coming in direct contact with a patient or when handling instruments or equipment contaminated with blood or other potentially infectious materials.

(i) Use new gloves before performing procedures on each patient.

(6) A denturist providing teeth whitening trays to patients must provide the patient with written and verbal information related to teeth whitening trays and teeth whitening solutions including the procedure, alternatives, risks and questions which is prescribed by the Agency. The denturist must obtain patient consent for the procedure described in this rule and retain in patient record. The Agency prescribed information and informed consent for teeth whitening trays and solutions can be accessed on the Agency Website at http://www.oregon.gov/OHLA/DT/pages/index.aspx

(7) A denturist is prohibited from providing patients prescription strength teeth whitening solutions.

Stat. Auth.: ORS 676.605, 676.615, 680.550 & 680.565
Stats. Implemented: ORS 676.605, 676.615, 680.550 & 680.565
Hist.: HD 4-1988, f. & cert. ef. 3-4-88; HD 4-1989, f. & cert. ef. 6-1-89; HD 13-1991(Temp), f. & cert. ef. 9-30-91; HD 3-1992, f. & cert. ef. 3-25-92, Subsections (9)(a) through (h) renumbered to 333-020-0090 and 333-020-0100; HD 22-1993, f. 12-30-93, cert. ef. 1-1-94; HDLP 3-1998, f. 6-26-98, cert. ef. 7-1-98, Renumbered from 333-020-0085; HLO 1-2003, f. 1-21-03, cert. ef. 2-1-03; HLO 2-2004, f. 6-29-04, cert. ef. 7-1-04; HLA 10-2013, f. & cert. ef. 7-1-13

331-420-0010

Practice Standards for Business Premises

(1) A licensed denturist must:

(a) Ensure all areas of the business premises where denture technology is practiced are kept clean and in good repair;

(b) Have a sterilization area, where cleaning and sterilization of reusable instruments is performed, separated from public areas, service areas and restrooms;

(c) Maintain washing accommodations in a clean and sanitary condition;

(d) Ensure all floors, walls and procedure surfaces where services are provided including counters, tables, and chairs are easily cleanable, non-absorbent and non-porous;

(e) Ensure pets or other animals are not permitted in the business facility. This prohibition does not apply to service animals recognized by the American with Disabilities Act;

(f) Ensure all disinfecting solutions or agents be kept at adequate strengths according to manufacturer’s instructions to maintain effectiveness, be free of foreign material and be available for immediate use at all times the business is open;

(g) Use equipment and instruments in a manner described in the manufacturer’s instructions which is consistent with the manufacturer’s intended use of the device by the FDA;

(h) Ensure chemicals are stored in labeled, closed containers;

(i) Ensure all waste material contaminated with blood or other potentially infectious materials, with exception of sharps, are deposited in a covered container following service for each patient; and

(j) Ensure all sharps are discarded in a sharps container which is a puncture-resistant, leak-proof container that can be closed for handling, storage, transportation, and disposal. The container must be labeled with the "Biohazard" symbol.

(2) The licensee must comply with all applicable rules and regulations of the Agency and other federal, state, county and local agencies. This includes the following:

(a) Building, fire, plumbing and electrical codes, and with exit and fire standards established by the Oregon Building Codes Division, and the Oregon Office of State Fire Marshal;

(b) Oregon Indoor Clean Air Act as it appears in ORS 433.835 through 433.875;

(c) Occupational Safety and Health Act Blood Borne Pathogens Standards, Universal Precautions and Exposure Control Plan under 29 CFR 1910.1030;

(d) Oregon Safe Employment Act pursuant to ORS Chapter 654 if an employee/employer relationship exists; and

(e) All applicable Occupational Safety and Health Act standards if an employee/employer relationship exists.

(f) All applicable recommendations from the Centers for Disease Control and Prevention.

(3) For the purpose of this rule "Sharps" means any object that can penetrate the skin, including but not limited to needles or scalpel blades.

(4) A licensee must ensure all procedures performed are done in a manner to avoid cross contamination of blood borne pathogens.

[Publications: Publications referenced are available from the agency.]

Stat. Auth.: ORS 680.550 & 680.565
Stats. Implemented: ORS 680.550 & 680.565
Hist.: HD 13-1991(Temp), f. & cert. ef. 9-30-91; HD 3-1992, f. & cert. ef. 3-25-92, Renumbered from 333-020-0085(9)(a) through (h); HD 22-1993, f. 12-30-93, cert. ef. 1-1-94; HDLP 3-1998, f. 6-26-98, cert. ef. 7-1-98, Renumbered from 333-020-0090; HLO 1-2003, f. 1-21-03 cert. ef. 2-1-03; HLA 10-2013, f. & cert. ef. 7-1-13

331-420-0020

Approved Sterilization and Disinfection Standards

(1) New gloves must be worn during any disinfection or sterilization procedure.

(2) The disinfection or sterilization process listed in subsection (4) or (5) of this rule is not required if disinfected or sterilized single-use prepackaged instruments, obtained from suppliers or manufacturers are used.

(3) All reusable instruments that come in direct contact with a client's skin or are exposed to blood or other potentially infectious materials must be disinfected or sterilized before use on a client or re-used on another client in accordance with subsection (4) or (5) of this rule.

(4) Approved cleaning and disinfection process for reusable instruments includes the following ordered method:

(a) Clean reusable instruments by manually brushing or swabbing visible foreign matter and rinsing the instruments with warm water and an appropriate detergent solution to remove blood and other potentially infectious materials;

(b) Immerse reusable instruments in a high level disinfectant defined under OAR 331-405-0020 and labeled accordingly; and

(c) Store disinfected instruments in a dry, disinfected, closed cabinet or other tightly-covered container reserved for the storage of disinfected instruments.

(5) Approved cleaning and sterilization process for reusable instruments includes the following ordered method:

(a) Clean reusable instruments by manually brushing or swabbing visible foreign matter and rinsing the instruments with warm water and an appropriate detergent solution to remove blood and other potentially infectious materials;

(b) Individually package reusable instruments using sterilization pouches that include a color indicator strip to assure sufficient temperature during each sterilization cycle. The date the sterilization was performed must be applied to the sterilization pouch;

(c) Place individually packaged reusable instruments in an autoclave sterilizer (steam or chemical), or dry heat sterilizer registered and listed with the Food and Drug Administration; and

(d) Store sterilized instruments individually packaged in a dry, disinfected, closed cabinet or other tightly-covered container reserved for the storage of sterilized instruments.

(6) If a denturist is using an autoclave or dry heat sterilizer under subsection (5) of this rule the denturist must have the autoclave or dry heat sterilizer biologically tested monthly (spore testing) verified through an independent laboratory, to assure all microorganisms have been destroyed and sterilization achieved. Biological spore test results must be immediately available at all times for inspection by the Agency and kept at facility premises for a minimum of two years.

(7) If a denturist is using an autoclave or dry heat sterilizer under subsection (5) of this rule they must ensure the entire device is cleaned and maintained in accordance with manufacturer’s instructions and a copy of the manufacturer’s recommended procedures for the operation of the device must be kept on file at the business premise.

(8) The expiration date for sterilized reusable instruments under subsection (5) of this rule is one year from the date of sterilization unless the integrity of the package is compromised.

(9) All surfaces that may be contaminated by blood or other potentially infectious materials must be disinfected with a high-level disinfectant defined under OAR 331-405-0020 and is labeled accordingly.

Stat. Auth.: ORS 676.605, 676.615, 680.550 & 680.565
Stats. Implemented: ORS 676.605, 676.615, 680.550 & 680.565
Hist.: HD 3-1992, f. & cert. ef. 3-25-92, Renumbered from 333-020-0085(9)(a) through (h); HD 22-1993, f. 12-30-93, cert. ef. 1-1-94; HDLP 3-1998, f. 6-26-98, cert. ef. 7-1-98, Renumbered from 333-020-0100; HDLP 1-2001, f. 3-21-01, cert. ef. 4-1-01; HLO 1-2003, f. 1-21-03, cert. ef. 2-1-03; HLO 2-2004, f. 6-29-04, cert. ef. 7-1-04; HLA 10-2013, f. & cert. ef. 7-1-13; HLA 4-2014(Temp), f. & cert ef. 7-1-14 thru 12-28-14

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